title: Relationship between 1-hour glucose challenge test results and perinatal outcomes.
abstract: OBJECTIVE
  To estimate the relationship between 1-hour 50 g glucose challenge test values and perinatal outcomes.
  
  
  METHODS
  This was a secondary analysis of data from a multicenter treatment trial of mild gestational diabetes mellitus. Women with glucose challenge test values of 135-199 mg/dL completed a 3-hour oral glucose tolerance test. Mild gestational diabetes mellitus was defined as fasting glucose less than 95 mg/dL and two or more abnormal oral glucose tolerance test values: 1-hour 180 mg/dL or more; 2-hour 155 mg/dL or more; and 3-hour 140 mg/dL or more. Our study included untreated women with glucose challenge test values of 135-139 mg/dL and 140-199 mg/dL and a comparison group with values less than 120 mg/dL. Primary outcomes included a perinatal composite (stillbirth, neonatal death, hypoglycemia, hyperbilirubinemia, neonatal hyperinsulinemia, and birth trauma), large for gestational age (LGA, birth weight above the 90 percentile based on sex-specific and race-specific norms), and macrosomia (greater than 4,000 g).
  
  
  RESULTS
  There were 436 women with glucose challenge test values less than 120 mg/dL and 1,403 with values of 135 mg/dL or more (135-139, n=135; 140-199, n=1,268). The composite perinatal outcome occurred in 25.6% of those with glucose challenge test values less than 120 mg/dL compared with 21.1% for values of 135-139 mg/dL and 35.3% for values of 140-199 mg/dL. Rates of LGA by group were 6.6%, 6.8%, and 12.4%, respectively. Rates of macrosomia by group were 7.8%, 6.1%, and 12.1%, respectively. Compared with glucose challenge test values less than 120 mg/dL, the adjusted odds ratios (ORs) (95% confidence intervals [CIs]) for values of 140-199 mg/dL were 1.48 (1.14-1.93) for the composite outcome, 1.97 (1.29-3.11) for LGA, and 1.61 (1.07-2.49) for macrosomia. For glucose challenge test values of 135-139 mg/dL, adjusted ORs and 95% CIs were 0.75 (0.45-1.21), 1.04 (0.44-2.24), and 0.75 (0.30-1.66), respectively. The subcategories with glucose challenge test values of 140-144 mg/dL and 145-149 mg/dL also were associated with an increase in selected outcomes when compared with those with values less than 120 mg/dL.
  
  
  CONCLUSIONS
  Glucose challenge test values of 135-139 mg/dL were not associated with adverse outcomes compared with values less than 120 mg/dL; however, glucose challenge test values of 140 mg/dL or more were associated with an increase in odds of the composite perinatal outcome, LGA, and macrosomia.
authors.affiliation: Departments of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama, The Ohio State University, Columbus, Ohio, University of Texas Health Science Center at Houston, Houston, Texas, University of Texas Southwestern Medical Center, Dallas, Texas, Columbia University, New York, New York, University of Utah, Salt Lake City, Utah, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, Drexel University, Philadelphia, Pennsylvania, Case Western Reserve University-MetroHealth Medical Center, Cleveland, Ohio, Wake Forest University Health Sciences, Winston-Salem, North Carolina, University of Texas Medical Branch, Galveston, Texas, University of Pittsburgh, Pittsburgh, Pennsylvania, Wayne State University, Detroit, Michigan, Northwestern University, Chicago, Illinois, and Oregon Health & Science University, Portland, Oregon; The George Washington University Biostatistics Center, Washington, DC; and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
authors.forename: Dana
authors.initials: D
authors.lastname: Figueroa
authors.forename: Mark B
authors.initials: MB
authors.lastname: Landon
authors.forename: Lisa
authors.initials: L
authors.lastname: Mele
authors.forename: Catherine Y
authors.initials: CY
authors.lastname: Spong
authors.forename: Susan M
authors.initials: SM
authors.lastname: Ramin
authors.forename: Brian
authors.initials: B
authors.lastname: Casey
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Wapner
authors.forename: Michael W
authors.initials: MW
authors.lastname: Varner
authors.forename: John M
authors.initials: JM
authors.lastname: Thorp
authors.forename: Anthony
authors.initials: A
authors.lastname: Sciscione
authors.forename: Patrick
authors.initials: P
authors.lastname: Catalano
authors.forename: Margaret
authors.initials: M
authors.lastname: Harper
authors.forename: George
authors.initials: G
authors.lastname: Saade
authors.forename: Steve N
authors.initials: SN
authors.lastname: Caritis
authors.forename: Yoram
authors.initials: Y
authors.lastname: Sorokin
authors.forename: Alan M
authors.initials: AM
authors.lastname: Peaceman
authors.forename: Jorge E
authors.initials: JE
authors.lastname: Tolosa
mesh_terms: D000328:Adult; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology*; D015337:Multicenter Studies as Topic; D011247:Pregnancy; D011256:Pregnancy Outcome; D016032:Randomized Controlled Trials as Topic; D014481:United States / Q000453:epidemiology; D055815:Young Adult